Adherence with an Acute Agitation Algorithm and Subsequent Restraint Use.

Autor: Jenkins M; Division of Pharmacy, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, MLC 2003, Cincinnati, OH, 45229, USA. meredith.jenkins@cchmc.org., Barrett MC; Division of Pharmacy, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, MLC 2003, Cincinnati, OH, 45229, USA., Frey T; Division of Emergency Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.; Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA., Bouvay K; Division of Emergency Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.; Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA., Barzman D; Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA.; Division of Child Psychiatry, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA., Kurowski EM; Division of Emergency Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.; Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA.
Jazyk: angličtina
Zdroj: The Psychiatric quarterly [Psychiatr Q] 2021 Sep; Vol. 92 (3), pp. 851-862. Date of Electronic Publication: 2020 Nov 20.
DOI: 10.1007/s11126-020-09860-0
Abstrakt: Timely use of pharmacological interventions to treat acute agitation has the potential to decrease physical restraint use. The aim of this study is to determine if adherence to standardized pharmacological recommendations for the treatment of acutely agitated pediatric patients decreases physical restraint use. Additionally, this study aims to identify predictors of physical restraint use and describe treatment related adverse events. This is a retrospective chart review of patient visits between September 1, 2016 and August 31, 2017. Patient visits were included if the patient presented to the pediatric emergency department, met ICD-10 codes, and received pharmacologic management or physical restraint to treat acute agitation. The differences in rate of physical restraint was assessed between patients treated according to the standardized pharmacological recommendations and patients who were not. 447 patients were included with a mean age of 13 years. No significant difference in physical restraint use was found when standardized pharmacological recommendations were followed compared to when they were not (P = 0.16). Only presentation on day shift when compared to evening shift resulted in increased odds of being restrained (OR 2.03; 95% CI 1.18, 3.50). Nine adverse events possibly related to medications were identified with none considered to be of significant clinical concern. Standardized pharmacological treatment recommendations was not associated with a decrease in physical restraint use for agitated patients presenting to the pediatric emergency department. The pharmacologic strategies utilized were generally safe and well tolerated in this patient population.
(© 2020. Springer Science+Business Media, LLC, part of Springer Nature.)
Databáze: MEDLINE
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